Risk factors and outcomes for late presentation for HIV-positive persons in europe: results from the collaboration of observational HIV epidemiological research europe study (COHERE)

Amanda Mocroft; Jens D Lundgren; Miriam Lewis Sabin; Antonella d'Arminio Monforte; Norbert Brockmeyer; Jordi Casabona; Antonella Castagna; Dominique Costagliola; Francois Dabis; Stéphane De Wit; Gerd Fätkenheuer; Hansjakob Furrer; Anne Johnson; Marios K Lazanas; Catherine Leport; Santiago Moreno; Niels Obel; Frank A Post; Joanne Reekie; Peter Reiss; Caroline Sabin; Adriane Skaletz-Rorowski; Ignacio Suarez-Lozano; Carlo Torti; Josiane Warszawski; Robert Zangerle; Céline Fabre-Colin; Jesper Kjaer; Genevieve Chene; Jesper Grarup; Ole Kirk; Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study in EuroCoord

doi:10.1371/journal.pmed.1001510

Risk factors and outcomes for late presentation for HIV-positive persons in europe: results from the collaboration of observational HIV epidemiological research europe study (COHERE)

Amanda Mocroft, Jens D Lundgren, Miriam Lewis Sabin, Antonella d'Arminio Monforte, Norbert Brockmeyer, Jordi Casabona, Antonella Castagna, Dominique Costagliola, Francois Dabis, Stéphane De Wit, Gerd Fätkenheuer, Hansjakob Furrer, Anne Johnson, Marios K Lazanas, Catherine Leport, Santiago Moreno, Niels Obel, Frank A Post, Joanne Reekie, Peter ReissCaroline Sabin, Adriane Skaletz-Rorowski, Ignacio Suarez-Lozano, Carlo Torti, Josiane Warszawski, Robert Zangerle, Céline Fabre-Colin, Jesper Kjaer, Genevieve Chene, Jesper Grarup, Ole Kirk, Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study in EuroCoord

Institut for Klinisk Medicin

205 Citationer (Scopus)

Abstract

Background:Few studies have monitored late presentation (LP) of HIV infection over the European continent, including Eastern Europe. Study objectives were to explore the impact of LP on AIDS and mortality.Methods and Findings:LP was defined in Collaboration of Observational HIV Epidemiological Research Europe (COHERE) as HIV diagnosis with a CD4 count <350/mm³or an AIDS diagnosis within 6 months of HIV diagnosis among persons presenting for care between 1 January 2000 and 30 June 2011. Logistic regression was used to identify factors associated with LP and Poisson regression to explore the impact on AIDS/death. 84,524 individuals from 23 cohorts in 35 countries contributed data; 45,488 were LP (53.8%). LP was highest in heterosexual males (66.1%), Southern European countries (57.0%), and persons originating from Africa (65.1%). LP decreased from 57.3% in 2000 to 51.7% in 2010/2011 (adjusted odds ratio [aOR] 0.96; 95% CI 0.95-0.97). LP decreased over time in both Central and Northern Europe among homosexual men, and male and female heterosexuals, but increased over time for female heterosexuals and male intravenous drug users (IDUs) from Southern Europe and in male and female IDUs from Eastern Europe. 8,187 AIDS/deaths occurred during 327,003 person-years of follow-up. In the first year after HIV diagnosis, LP was associated with over a 13-fold increased incidence of AIDS/death in Southern Europe (adjusted incidence rate ratio [aIRR] 13.02; 95% CI 8.19-20.70) and over a 6-fold increased rate in Eastern Europe (aIRR 6.64; 95% CI 3.55-12.43).Conclusions:LP has decreased over time across Europe, but remains a significant issue in the region in all HIV exposure groups. LP increased in male IDUs and female heterosexuals from Southern Europe and IDUs in Eastern Europe. LP was associated with an increased rate of AIDS/deaths, particularly in the first year after HIV diagnosis, with significant variation across Europe. Earlier and more widespread testing, timely referrals after testing positive, and improved retention in care strategies are required to further reduce the incidence of LP.Please see later in the article for the Editors' Summary.

Originalsprog	Engelsk
Tidsskrift	P L o S Medicine (Online)
Vol/bind	10
Udgave nummer	9
Sider (fra-til)	e1001510
ISSN	1549-1277
DOI	https://doi.org/10.1371/journal.pmed.1001510
Status	Udgivet - 3 okt. 2013

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10.1371/journal.pmed.1001510

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Mocroft, A., Lundgren, J. D., Sabin, M. L., Monforte, A. DA., Brockmeyer, N., Casabona, J., Castagna, A., Costagliola, D., Dabis, F., De Wit, S., Fätkenheuer, G., Furrer, H., Johnson, A., Lazanas, M. K., Leport, C., Moreno, S., Obel, N., Post, F. A., Reekie, J., ... Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study in EuroCoord (2013). Risk factors and outcomes for late presentation for HIV-positive persons in europe: results from the collaboration of observational HIV epidemiological research europe study (COHERE). P L o S Medicine (Online), 10(9), e1001510. https://doi.org/10.1371/journal.pmed.1001510

Risk factors and outcomes for late presentation for HIV-positive persons in europe : results from the collaboration of observational HIV epidemiological research europe study (COHERE). / Mocroft, Amanda; Lundgren, Jens D; Sabin, Miriam Lewis et al.

I: P L o S Medicine (Online), Bind 10, Nr. 9, 03.10.2013, s. e1001510.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning

Mocroft, A, Lundgren, JD, Sabin, ML, Monforte, ADA, Brockmeyer, N, Casabona, J, Castagna, A, Costagliola, D, Dabis, F, De Wit, S, Fätkenheuer, G, Furrer, H, Johnson, A, Lazanas, MK, Leport, C, Moreno, S, Obel, N, Post, FA, Reekie, J, Reiss, P, Sabin, C, Skaletz-Rorowski, A, Suarez-Lozano, I, Torti, C, Warszawski, J, Zangerle, R, Fabre-Colin, C, Kjaer, J, Chene, G, Grarup, J, Kirk, O & Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study in EuroCoord 2013, 'Risk factors and outcomes for late presentation for HIV-positive persons in europe: results from the collaboration of observational HIV epidemiological research europe study (COHERE)', P L o S Medicine (Online), bind 10, nr. 9, s. e1001510. https://doi.org/10.1371/journal.pmed.1001510

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title = "Risk factors and outcomes for late presentation for HIV-positive persons in europe: results from the collaboration of observational HIV epidemiological research europe study (COHERE)",

abstract = "Background:Few studies have monitored late presentation (LP) of HIV infection over the European continent, including Eastern Europe. Study objectives were to explore the impact of LP on AIDS and mortality.Methods and Findings:LP was defined in Collaboration of Observational HIV Epidemiological Research Europe (COHERE) as HIV diagnosis with a CD4 count <350/mm3or an AIDS diagnosis within 6 months of HIV diagnosis among persons presenting for care between 1 January 2000 and 30 June 2011. Logistic regression was used to identify factors associated with LP and Poisson regression to explore the impact on AIDS/death. 84,524 individuals from 23 cohorts in 35 countries contributed data; 45,488 were LP (53.8%). LP was highest in heterosexual males (66.1%), Southern European countries (57.0%), and persons originating from Africa (65.1%). LP decreased from 57.3% in 2000 to 51.7% in 2010/2011 (adjusted odds ratio [aOR] 0.96; 95% CI 0.95-0.97). LP decreased over time in both Central and Northern Europe among homosexual men, and male and female heterosexuals, but increased over time for female heterosexuals and male intravenous drug users (IDUs) from Southern Europe and in male and female IDUs from Eastern Europe. 8,187 AIDS/deaths occurred during 327,003 person-years of follow-up. In the first year after HIV diagnosis, LP was associated with over a 13-fold increased incidence of AIDS/death in Southern Europe (adjusted incidence rate ratio [aIRR] 13.02; 95% CI 8.19-20.70) and over a 6-fold increased rate in Eastern Europe (aIRR 6.64; 95% CI 3.55-12.43).Conclusions:LP has decreased over time across Europe, but remains a significant issue in the region in all HIV exposure groups. LP increased in male IDUs and female heterosexuals from Southern Europe and IDUs in Eastern Europe. LP was associated with an increased rate of AIDS/deaths, particularly in the first year after HIV diagnosis, with significant variation across Europe. Earlier and more widespread testing, timely referrals after testing positive, and improved retention in care strategies are required to further reduce the incidence of LP.Please see later in the article for the Editors' Summary.",

author = "Amanda Mocroft and Lundgren, {Jens D} and Sabin, {Miriam Lewis} and Monforte, {Antonella d'Arminio} and Norbert Brockmeyer and Jordi Casabona and Antonella Castagna and Dominique Costagliola and Francois Dabis and {De Wit}, St{\'e}phane and Gerd F{\"a}tkenheuer and Hansjakob Furrer and Anne Johnson and Lazanas, {Marios K} and Catherine Leport and Santiago Moreno and Niels Obel and Post, {Frank A} and Joanne Reekie and Peter Reiss and Caroline Sabin and Adriane Skaletz-Rorowski and Ignacio Suarez-Lozano and Carlo Torti and Josiane Warszawski and Robert Zangerle and C{\'e}line Fabre-Colin and Jesper Kjaer and Genevieve Chene and Jesper Grarup and Ole Kirk and {Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study in EuroCoord}",

year = "2013",

month = oct,

day = "3",

doi = "10.1371/journal.pmed.1001510",

language = "English",

volume = "10",

pages = "e1001510",

journal = "P L o S Medicine (Online)",

issn = "1549-1277",

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TY - JOUR

T1 - Risk factors and outcomes for late presentation for HIV-positive persons in europe

T2 - results from the collaboration of observational HIV epidemiological research europe study (COHERE)

AU - Mocroft, Amanda

AU - Lundgren, Jens D

AU - Sabin, Miriam Lewis

AU - Monforte, Antonella d'Arminio

AU - Brockmeyer, Norbert

AU - Casabona, Jordi

AU - Castagna, Antonella

AU - Costagliola, Dominique

AU - Dabis, Francois

AU - De Wit, Stéphane

AU - Fätkenheuer, Gerd

AU - Furrer, Hansjakob

AU - Johnson, Anne

AU - Lazanas, Marios K

AU - Leport, Catherine

AU - Moreno, Santiago

AU - Obel, Niels

AU - Post, Frank A

AU - Reekie, Joanne

AU - Reiss, Peter

AU - Sabin, Caroline

AU - Skaletz-Rorowski, Adriane

AU - Suarez-Lozano, Ignacio

AU - Torti, Carlo

AU - Warszawski, Josiane

AU - Zangerle, Robert

AU - Fabre-Colin, Céline

AU - Kjaer, Jesper

AU - Chene, Genevieve

AU - Grarup, Jesper

AU - Kirk, Ole

AU - Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study in EuroCoord

PY - 2013/10/3

Y1 - 2013/10/3

N2 - Background:Few studies have monitored late presentation (LP) of HIV infection over the European continent, including Eastern Europe. Study objectives were to explore the impact of LP on AIDS and mortality.Methods and Findings:LP was defined in Collaboration of Observational HIV Epidemiological Research Europe (COHERE) as HIV diagnosis with a CD4 count <350/mm3or an AIDS diagnosis within 6 months of HIV diagnosis among persons presenting for care between 1 January 2000 and 30 June 2011. Logistic regression was used to identify factors associated with LP and Poisson regression to explore the impact on AIDS/death. 84,524 individuals from 23 cohorts in 35 countries contributed data; 45,488 were LP (53.8%). LP was highest in heterosexual males (66.1%), Southern European countries (57.0%), and persons originating from Africa (65.1%). LP decreased from 57.3% in 2000 to 51.7% in 2010/2011 (adjusted odds ratio [aOR] 0.96; 95% CI 0.95-0.97). LP decreased over time in both Central and Northern Europe among homosexual men, and male and female heterosexuals, but increased over time for female heterosexuals and male intravenous drug users (IDUs) from Southern Europe and in male and female IDUs from Eastern Europe. 8,187 AIDS/deaths occurred during 327,003 person-years of follow-up. In the first year after HIV diagnosis, LP was associated with over a 13-fold increased incidence of AIDS/death in Southern Europe (adjusted incidence rate ratio [aIRR] 13.02; 95% CI 8.19-20.70) and over a 6-fold increased rate in Eastern Europe (aIRR 6.64; 95% CI 3.55-12.43).Conclusions:LP has decreased over time across Europe, but remains a significant issue in the region in all HIV exposure groups. LP increased in male IDUs and female heterosexuals from Southern Europe and IDUs in Eastern Europe. LP was associated with an increased rate of AIDS/deaths, particularly in the first year after HIV diagnosis, with significant variation across Europe. Earlier and more widespread testing, timely referrals after testing positive, and improved retention in care strategies are required to further reduce the incidence of LP.Please see later in the article for the Editors' Summary.

AB - Background:Few studies have monitored late presentation (LP) of HIV infection over the European continent, including Eastern Europe. Study objectives were to explore the impact of LP on AIDS and mortality.Methods and Findings:LP was defined in Collaboration of Observational HIV Epidemiological Research Europe (COHERE) as HIV diagnosis with a CD4 count <350/mm3or an AIDS diagnosis within 6 months of HIV diagnosis among persons presenting for care between 1 January 2000 and 30 June 2011. Logistic regression was used to identify factors associated with LP and Poisson regression to explore the impact on AIDS/death. 84,524 individuals from 23 cohorts in 35 countries contributed data; 45,488 were LP (53.8%). LP was highest in heterosexual males (66.1%), Southern European countries (57.0%), and persons originating from Africa (65.1%). LP decreased from 57.3% in 2000 to 51.7% in 2010/2011 (adjusted odds ratio [aOR] 0.96; 95% CI 0.95-0.97). LP decreased over time in both Central and Northern Europe among homosexual men, and male and female heterosexuals, but increased over time for female heterosexuals and male intravenous drug users (IDUs) from Southern Europe and in male and female IDUs from Eastern Europe. 8,187 AIDS/deaths occurred during 327,003 person-years of follow-up. In the first year after HIV diagnosis, LP was associated with over a 13-fold increased incidence of AIDS/death in Southern Europe (adjusted incidence rate ratio [aIRR] 13.02; 95% CI 8.19-20.70) and over a 6-fold increased rate in Eastern Europe (aIRR 6.64; 95% CI 3.55-12.43).Conclusions:LP has decreased over time across Europe, but remains a significant issue in the region in all HIV exposure groups. LP increased in male IDUs and female heterosexuals from Southern Europe and IDUs in Eastern Europe. LP was associated with an increased rate of AIDS/deaths, particularly in the first year after HIV diagnosis, with significant variation across Europe. Earlier and more widespread testing, timely referrals after testing positive, and improved retention in care strategies are required to further reduce the incidence of LP.Please see later in the article for the Editors' Summary.

U2 - 10.1371/journal.pmed.1001510

DO - 10.1371/journal.pmed.1001510

M3 - Journal article

C2 - 24137103

SN - 1549-1277

VL - 10

SP - e1001510

JO - P L o S Medicine (Online)

JF - P L o S Medicine (Online)

IS - 9

ER -

Risk factors and outcomes for late presentation for HIV-positive persons in europe: results from the collaboration of observational HIV epidemiological research europe study (COHERE)

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